Tag laser issue. Permanent silicone oil in eye..

[CathyUssery]

I   Silicone oil in both eyes due to severe diabetic retinopathy. I had two unsussfull vitrectomies and had them redone with the silicone oil. After I had about 20/40 vision corrected in one eye with no peripheral vision at all. I am completely dark in my right eye but can still detect light. I developed a large very fast growing cataract and after removal had to have a tag laser a month later. I had almost instant results but within 24 hours my vision is blurry and cloudy again. My vision stands at 20/200 now corrected. I'm at a loss. Is there any hope I can get any better results with any other procedures?

[John C Hagan III, MD, FACS, FAAO]

It's "Yag" laser.   Your best option might be to see a different, highly regarded retina surgeon, perhaps one associated with a medical school for a second opinion. There is no way I can tell you anything about the prognosis of your eye except these are devastating problems that 30 years ago ended up completely blind.  Now we have a chance to retain some vision.

[CathyUssery]

I have a wonderful retina surgeon. I have been to Duke University twice for second  opinions on the retina part so I understand nothing can be done about the back of my eye. My concern is that after cataract surgery and YAG laser treatment my vision seems to be getting worse. My retina specialist and cornea specialist keep bouncing me back and forth with no results. I use speech to text so sometimes my grammar punctuation and spelliigs  off. Sorry about that.

[John C Hagan III, MD, FACS, FAAO]

The front of the eye is easily examined. So either your retina or cataract surgeon should be able to tell if any problem in the cornea,  anterior chamber, intraocular lens or posterior capsule. NOTE:  retina and vitreous and macular problems sometimes worsen after yag capsulotomy. it would have been on the consent you signed.

[CathyUssery]

The surgeon who did my cataract surgery and yag laser afterwards had never performed these surgeries on someone who has perminent silicone oil in there I. And I am confident That he did a lot of research and spoke to many colleagues before he performed the procedures. Is it possible that the wrong IOL West placed in my eye? Also, is it possible that I may need a nother yag laser treatments?  Again, sorry about the grammar punctuation and spelling I have to use speech to text because of my vision. I used to be  Excellent with the computer  It's so frustrating

[John C Hagan III, MD, FACS, FAAO]

Not likely but possible some of the oil might have come into the front of the eye from the yag laser opening. That should be checked for.  

[CathyUssery]

I do have visible bumps and spots on the white part of my eye from where the oil has leaked through but neither my retina surgeon or regular ophthalmologist has said that is an issue. If the oil has come through the yag laser opening can that be fixed?

[John C Hagan III, MD, FACS, FAAO]

Yes but it might involve some surgery to remove the oil.  Hopefully your IOL is not silicone as the oil is  damaging to silicone but not acrylic IOLs see this study:  https://www.ncbi.nlm.nih.gov/pubmed/9304645

[CathyUssery]

Thank you so much for answering all of my questions. As I stated before I have a brilliant retina surgeon. Even the doctors at Duke University say he is the best around. And fortunately he has a horrible bedside manner And is very reluctant to give me any information and less I specifically ask for it. As a physician you probably know a lot of patience don't ask questions that they should while they have the physician in front of them. I am badd about that I am one of those people who always forgets to ask what I meant to while I am there. Thank you very much for the information on the article. I don't understand it myself but I have copied it and I will show it to my physician next time I see him I do know that well cannot be removed from my I. My doctor has likened my retina to a trampoline saying that if he removed the oil my retina will pop and probably blind to me permanently so unfortunately that is not a possibility. I have always wondered if maybe I need an "oil change??" Is that something can be done safely

[John C Hagan III, MD, FACS, FAAO]

Best thing then is to make a list of questions and take with you to  Dr. Bad Manner's visit. And don't let him leave till answered. They will not take oil out unless they have to.

[CathyUssery]

A couple of days ago I woke up to the clearest vision I have had in years. Then I put on my glasses and it got worse. The glasses that I had made after the vitrectomy and oil was put in are way too strong now which is absolutely fabulous. I still have a little cloudiness like I have another cataract which I know isn't possible. In any case I am extremely happy that I can see better but hopefully they can do something about the cloudiness otherwise everything else looks great in my retina is stable for now. Thank you so very much for all your advice. Since I joined this community I really like reading your responses to people's questions.

[John C Hagan III, MD, FACS, FAAO]

Oh happy day.  Probably should get into your comprehensive Eye MD and get a newer, glasses RX that isn't too strong.  Pleased you have found this forum helpful.

[CathyUssery]

So I was hoping my eyesight would be stable for a while. Over the last several days I have noticed it clouding up again. I haven't noticed any new blurriness but I can definitely tell a white milky cloud is reappearing. I don't see my ophthalmologist for a couple more weeks do you think I should go in sooner?  Any idea of what could be causing this? It's just on the  Left eye that I had the cataract surgery on and subsequent YAG laser treatment done on.

[John C Hagan III, MD, FACS, FAAO]

Yes I think you should call and go in earlier, this coming week would be great.  A Yag laser capsulotomy is a simple procedure so its likely what is changing is the back of your eye not the front.

[CathyUssery]

I saw  My eye doctor today.

[CathyUssery]

I sent that last post before I finished it lol. I am happy to reports that like I was hoping he has to do the YAG laser treatment again. He thinks because of the oil in my eye that it is pushing on whatever and not letting the haze come out. He wants to do some research and consult with my retina surgeon and Perform the procedure in  10 days. He put me on ptolensa and pred forte  As well as a course of anti viral medication because I had herpes in my eye at 1 time  He took pictures of the back of the eye and stated I have a little bit of inflammation but nothing to be too concerned about. Hopefully this works this time  My vision got to 20/60 corrected today which is excellent for me and hopefully We can get it even better after the next YAG treatment. Thank you again for all your advice and encouragement through all this I will keep you informed of the results if you want.

[John C Hagan III, MD, FACS, FAAO]

Very happy to hear the good news. If you would be so kind as to post a follow up.  Many people with problems would like to know how this eventually turns out.